• Peter W Rose, Sue Ziebland, Anthony Harnden, Richard Mayon-White, David Mant, and Oxford Childhood Infection Study group (OXCIS).
• Department of Primary Health Care, University of Oxford, Old Road Campus, Old Road, Headington, Oxford. OX3 7LF, UK. peter.rose@dphpc.ox.ac.uk
• Fam Pract. 2006 Apr 1; 23 (2): 226-32.

BackgroundAcute infective conjunctivitis in children is a common presentation in primary care. Treatment is usually with antibiotics and prescribing may be affected by non-clinical factors.AimsTo investigate the non-clinical determinants of the management of acute infective conjunctivitis in children.DesignQualitative interviews with GPs and a questionnaire survey of parents of children with acute infective conjunctivitis and teachers.SettingGPs in Sheffield and Berkshire and parents of children with acute infective conjunctivitis and schools in Oxfordshire.MethodsSemi-structured telephone interviews of 39 GPs. Questionnaire survey of 326 parents of children enrolled into a trial of acute infective conjunctivitis treatment. Questionnaire survey of 223 nurseries and primary schools in Oxfordshire.ResultsAll three groups agreed that acute infective conjunctivitis was a mild condition. Parents were certain about the benefits of antibiotic treatment and sought early consultations with their GP in a desire to get their child back to school. GPs sometimes collude with a parent's request to prescribe to enable school attendance. Despite this 54.2% (95%CI 48.5-59.8%) children missed a mean of 1.85 days from school and 28.6% of parents (95%CI 23.5-33.7%) missed a mean of 1.5 days off work.ConclusionSocial factors, including the need for children to attend day care or school and parents to go to work, contribute to the decision to prescribe antibiotics for children with acute infective conjunctivitis. Understanding these issues and changing school policies in line with national guidance may reduce pressure on GPs to prescribe for this condition.

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